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目的:探讨2型糖尿病(T2DM)合并下肢动脉血管病变(LEAD)的早期检查方法及其危险因素。方法:采用糖尿病足筛查箱中的MD2超声多普勒仪对67例T2DM患者进行踝肱指数(ABI)测定,将ABI<0.9归为LEAD组,ABI>0.9归为非LEAD组,比较两组患者的年龄、病程、体重指数(BMI)及空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)水平。结果:67例患者中有21例ABI<0.9,占31.3%。与非LEAD组比较,LEAD组患者年龄大、病程长,BMI、2 h PG、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、收缩压(SBP)、舒张压(DBP)均明显升高,差异有统计学意义(P<0.05)。结论:年龄大、病程长、餐后高血糖、TG高、HbA1c高、LDL-C高是T2DM并下肢动脉血管病变(LEAD)的主要危险因素。常规进行ABI检测可早期发现T2DM合并LEAD患者,降糖、调脂、降压、减重等综合治疗能降低LEAD的发病率。
Objective: To investigate the early detection methods and risk factors of type 2 diabetes mellitus (T2DM) with lower extremity arterial disease (LEAD). Methods: Ankle-brachial index (ABI) was measured in 67 T2DM patients by using MD2 ultrasonic Doppler in diabetic foot screening box. ABI <0.9 was classified as LEAD group, ABI> 0.9 was classified as non-LEAD group, The patients’ age, course of disease, body mass index (BMI), fasting blood glucose (FPG), 2 h postprandial blood glucose (2 h PG) and HbA1c levels were measured. Results: Among the 67 patients, 21 had ABI <0.9, accounting for 31.3%. Compared with non-LEAD group, patients in LEAD group were older, had longer duration, BMI, 2 h PG, triglyceride (TG), LDL-C, SBP and DBP, Were significantly higher, the difference was statistically significant (P <0.05). Conclusion: The main risk factors of T2DM and lower extremity arterial disease (LEAD) are older age, longer duration, postprandial hyperglycemia, high TG, high HbA1c and high LDL-C. Routine ABI testing can be early detection of T2DM patients with LEAD, hypoglycemic, lipid-lowering, antihypertensive, weight loss and other comprehensive treatment can reduce the incidence of LEAD.